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Association between radiotherapy protocol variations and outcome in the CONVERT trial
Romaana Mir1,2,3, Nicki Groom1,2, Hitesh B Mistry4,5
1National Radiotherapy Trials Quality Assurance (RTTQA) Group, Mount Vernon Cancer Centre, UK.
Clinical and Translational Radiation Oncology
|December 29, 2022
Summary
Radiotherapy quality assurance (QA) in the CONVERT trial found significant organ at risk contouring deviations. However, these protocol variations did not impact patient toxicity or survival outcomes.
Area of Science:
- Radiation Oncology
- Clinical Trials
- Quality Assurance
Background:
- Radiotherapy quality assurance (QA) is crucial for effective cancer treatment delivery.
- The CONVERT trial investigated the impact of protocol variations on patient outcomes.
Purpose of the Study:
- To conduct a comprehensive QA review of radiotherapy planning in the CONVERT trial.
- To assess the impact of contouring and dosimetry variations on toxicity and survival.
Main Methods:
- Retrospective review of radiotherapy plans from 93 patients.
- Re-contouring of organs at risk (OAR) and re-application of treatment plans.
- Analysis of protocol compliance and dosimetric data.
Main Results:
- High rates of non-compliance for organs at risk contours (heart, lung, spinal cord).
- 11.8% of heart structures exceeded protocol-defined dosimetric constraints.
- No significant association between unacceptable variations and increased toxicity, progression-free survival (PFS), or overall survival (OS).
Conclusions:
- Non-protocol compliant contours were linked to increased radiation dose to the heart.
- Despite deviations, unacceptable protocol variations did not negatively affect patient outcomes in this cohort.
- Standardized radiotherapy QA reporting is essential for clinical trials and practice.
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